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OCTA:现行方法和临床应用的一个综合回顾

Kashani, A.H., Chen, C.L., Gahm, J.K., et al.

期刊名称:Progress in Retinal and Eye Research

卷期:2017年第60卷

关键词:
临床应用 方法

兴齐制药 沈阳兴齐眼药股份有限公司是专业从事眼科药物研发、生产及销售的国家级火炬高新技术企业。公司成立三十多年来,秉承“经营健康、缔造光明”的企业理念,以“专心、专注、专业”的工作精神投入到人类眼健康产业。目前,公司拥有抗菌药、抗炎药、人工泪液、角膜修复药、抗疲劳药、散瞳药、手术用药、干眼治疗药等八大系列十五个重点产品,为眼科疾病治疗领域提供了高品质的产品。

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摘要

摘要:OCT在过去10 - 20年中彻底改变了眼科实践。 OCT技术的进步已经产生了新的基于OCT方法。 OCT-血管造影术(OCTA)是自2016年年底被FDA批准以来迅速获得临床验收的一种方法。OCTA图像基于来自视网膜血管和神经感觉组织的光可变反向散射。由于来自视网膜组织的反向散射光的强度和相位可根据组织的固有运动而变化(例如,红细胞移动,但是神经感觉组织是静态的),OCTA图像是基本的运动对比度图像。这种运动对比成像以有效的方式提供了视网膜血管系统的可靠的,高分辨率和非侵入性图像。在许多情况下,这些图像正在接近组织学水平分辨率。这种前所未有的与简单,快速和无创的成像平台相结合的解决方案可以进行大量的基础和临床研究应用。 OCTA证实了许多重要的临床发现,包括黄斑毛细血管扩张面积,灌注受损,微动脉瘤,毛细血管重塑,某些类型的视网膜内积液和许多其他的新生血管形成。更重要的是,OCTA提供了从未有过的高分辨率信息。相应地,OCTA已经用于评估视网膜血管疾病,包括糖尿病性视网膜病变(DR),视网膜静脉闭塞(RVO),葡萄膜炎,视网膜动脉闭塞和年龄相关性黄斑变性等。在这次综述中,我们将讨论用于创建OCTA图像的方法,根据侵入性染料成像研究(例如荧光素血管造影术)的OCTA实际应用,并回顾OCTA用于研究和临床实践的临床研究。

OCT has revolutionized the practice of ophthalmology over the past 10-20 years. Advances in OCT technology have allowed for the creation of novel OCT-based methods. OCT-Angiography (OCTA) is one such method that has rapidly gained clinical acceptance since it was approved by the FDA in late 2016. OCTA images are based on the variable backscattering of light from the vascular and neurosensory tissue in the retina. Since the intensity and phase of backscattered light from retinal tissue varies based on the intrinsic movement of the tissue (e.g. red blood cells are moving, but neurosensory tissue is static), OCTA images are essentially motion-contrast images. This motion-contrast imaging provides reliable, high resolution, and non-invasive images of the retinal vasculature in an efficient manner. In many cases, these images are approaching histology level resolution. This unprecedented resolution coupled with the simple, fast and non-invasive imaging platform have allowed a host of basic and clinical research applications. OCTA demonstrates many important clinical findings including areas of macular telangiectasia, impaired perfusion, microaneurysms, capillary remodeling, some types of intraretinal fluid, and neovascularization among many others. More importantly, OCTA provides depth-resolved information that has never before been available. Correspondingly, OCTA has been used to evaluate a spectrum of retinal vascular diseases including diabetic retinopathy (DR), retinal venous occlusion (RVO), uveitis, retinal arterial occlusion, and age-related macular degeneration among others. In this review, we will discuss the methods used to create OCTA images, the practical applications of OCTA in light of invasive dye-imaging studies (e.g. fluorescein angiography) and review clinical studies demonstrating the utility of OCTA for research and clinical practice.


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